Individual
MR. GLENN JOSEPH BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
351 NORTH AVE BURLINGTON, BURLINGTON, VT 05401
(802) 658-6110
(802) 860-0451
Mailing address
351 NORTH AVE, BURLINGTON, VT 05401
(802) 658-6110
(802) 860-0451
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0890000229
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008247
—
VT
Enumeration date
07/31/2006
Last updated
07/08/2007
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